Public health is the art and science of preventing disease, promoting and protecting population health, and extending life through organized local and global efforts (Acheson 1998: http://www.archive.official-documents.co.uk/document/doh/ih/ih.htm). Whilst clinical medicine is part of the overall public health effort, the broad mandate of public health includes identifying underlying political, social, behavioural, and environmental determinants of health outcomes, with a particular focus on reducing social and health inequalities ( Beaglehole 2003 ).
The World Health Organization defines health as a ‘complete state of physical, mental and social well-being and not merely the absence of disease or infirmity’. Whilst criticized as too utopian and unachievable by some, ( Nutbeam 1986 ; Sax 1990 ), it aptly presents the broad nature of health in its many meanings, influences, and outcomes, guiding its conception away from the purely biomedical perspective.
The International Association for the Study of Forced Migration (IASFM) describes forced migration as ‘a general term that refers to the movement of refugees and internally displaced people (those displaced by conflicts) as well as people displaced by natural or environmental disasters, chemical or nuclear disasters, famine, or development projects’. The main causes of involuntary displacement are wars and armed conflicts, although natural disasters and development projects are also factors. According to the United Nations High Commissioner for Refugees (UNHCR), there are some 50 million uprooted people around the world, including both refugees and internally displaced persons (IDPs), of whom around 75–80 per cent are women and children.
The legal definition of a ‘refugee’ is a person residing outside his or her country of nationality, who is unable or unwilling to return because of a ‘well-founded fear of persecution on account of race, religion, nationality, membership in a political social group, or political opinion’ (Article 1 of the 1951 United Nations Convention Relating to the Status of Refugees). The most widely used definition of IDPs is one presented in a 1992 report of the Secretary-General of the United Nations (UN), which identifies them as ‘persons who have been forced to flee their homes suddenly or unexpectedly in large numbers, as a result of armed conflict, internal strife, systematic violations of human rights or natural or man-made disasters, and who are within the territory of their own country.’